Anaesthesia preadmission assessment: a new approach through use of a screening questionnaire.
OBJECTIVE
The preadmission assessment of patients one to two weeks preoperatively has become the standard across North America. We have devised a new approach that utilises a preoperative screening questionnaire, and this study attempted to determine the effectiveness of this technique.


METHODS
Over six weeks, the attending anaesthetist for each patient undergoing non-cardiac surgery processed through the preadmission clinic (PAC) completed a study survey. This survey questioned if the assessment was appropriate with reasons, the consequences of no assessment, and if time was saved/lost on the day of surgery.


RESULTS
Three hundred and seventy patients were processed (243 same-day (SD), 111 outpatient (O/P), and 16 inpatients (I/P)). Of these, 224 were assessed in the PAC (101 by medicine, 84 by anaesthesia and 39 by both): 42% (94) based on the questionnaire, 12% (26) due to consultation, and 46% (104) due to positive questionnaires and consultation. The physician assessments were appropriate 184/219 (84%) times, inappropriate in 35 (16%), while there was no answer for five. Assessments were inappropriate because 25/35 (71%) were unnecessary, while in nine (26%) the patient was not optimised. Of the patients not assessed in the PAC only 9/145 (6%) should have been assessed.


CONCLUSIONS
The use of our screening tool in combination with direct referrals appropriately determines assessment needs of patients and allows for more efficient use of medical personnel in the PAC.
Badner
N H
NH
Department of Anaesthesia, University Campus, London Health Sciences Centre, Ontario, Canada. nbadner@julian.uwo.ca
Craen
R A
RA
Paul
T L
TL
Doyle
J A
JA
D000556:Ambulatory Surgical Procedures; D000768:Anesthesia, General; D000776:Anesthesiology; D019411:Clinical Laboratory Techniques; D003933:Diagnosis; D005069:Evaluation Studies as Topic; D006304:Health Status; D006305:Health Status Indicators; D006760:Hospitalization; D006801:Humans; D010343:Patient Admission; D010820:Physicians; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012017:Referral and Consultation; D012680:Sensitivity and Specificity; D013514:Surgical Procedures, Operative; D011795:Surveys and Questionnaires; D013997:Time Factors